Ana Marice Teixeira Ladeia

Magnesium Replacement Does Not Improve Insulin Resistance in Patients With Metabolic Syndrome: A 12-Week Randomized Double-Blind Study

Background To evaluate the effect of magnesium (Mg) replacement on insulin resistance and cardiovascular risk factors in women with metabolic syndrome (MS) without diabetes. Methods This 12-week clinical randomized double-blind study compared the effects of 400 mg/day of Mg with those of a placebo (n = 72) on fasting glucose, insulin, HOMA-IR, lipid profile and CRP. Mg was measured in serum (SMg) and in mononuclear cells (MMg). Results Hypomagnesemia (SMg < 1.7 mg/dL) was seen in 23.2% of patients and intracellular depletion in 36.1% of patients. The MMg means were lower in patients with obesity (0.94 ± 0.54 μg/mg vs. 1.19 ± 0.6 μg/mg, P = 0.04), and insulin resistance (0.84 ± 0.33 μg/mg vs. 1.14 ± 0.69 µg/mg, P < 0.05). Mg replacement did not alter SMg (1.82 ± 0.14 mg/dL vs. 1.81 ± 0.16 mg/dL, P = 0.877) and tended to increment MMg (0.90 ± 0.40 μg/mg vs. 1.21 ± 0.73 μg/mg, P = 0.089). HOMA-IR did not alter in interventions nor in placebo group (3.2 ± 2.0 to 2.8 ± 1.9, P = 0.368; 3.6 ± 1.9 to 3.2 ± 1.8, respectively), neither did other metabolic parameters. Conclusion Serum and intracellular Mg depletion is common in patients with MS; however, Mg replacement in recommended dosage did not increase significantly Mg levels, neither reduced insulin resistance or metabolic control.

Prevalence and variables associated with physical inactivity in individuals with high and low socioeconomic status

BACKGROUND: Studies that considered only the leisure physical activity found that the physical inactivity is higher among lower-income individuals. There is a possibility that this association shows modifications, when considering transportation, work and domestic activities. OBJECTIVE: To determine whether there is a difference between the prevalence of physical inactivity between individuals of high and low socioeconomic levels. METHODS: The sample consisted of individuals of both sexes, aged 18 or older, from two groups of different socioeconomic levels. The low socioeconomic level (LSEL) group consisted of the parents of students from a public school. The high socioeconomic level (HSEL) group consisted of the parents of students from a private College. The International Physical Activity Questionnaire (IPAQ) was used to determine the level of physical activity. RESULTS: A total of 91 individuals were evaluated in the LSEL group and 59 in the HSEL group. In the LSEL group, 42.9% (39) of the individuals were classified as insufficiently active, compared to 57.6% (34) of individuals in the HSEL group. Taking as a parameter of physical inactivity the time of weekly physical activity < 150 minutes, there was a decrease in the classification of inactivity in both groups, although with the maintenance of higher inactivity among individuals of HSEL (49.2% vs 28.6%; p= 0.01). CONCLUSION: The individuals of HSEL are more sedentary than the individuals of LSEL.BACKGROUND Studies that considered only the leisure physical activity found that the physical inactivity is higher among lower-income individuals. There is a possibility that this association shows modifications, when considering transportation, work and domestic activities. OBJECTIVE To determine whether there is a difference between the prevalence of physical inactivity between individuals of high and low socioeconomic levels. METHODS The sample consisted of individuals of both sexes, aged 18 or older, from two groups of different socioeconomic levels. The low socioeconomic level (LSEL) group consisted of the parents of students from a public school. The high socioeconomic level (HSEL) group consisted of the parents of students from a private College. The International Physical Activity Questionnaire (IPAQ) was used to determine the level of physical activity. RESULTS A total of 91 individuals were evaluated in the LSEL group and 59 in the HSEL group. In the LSEL group, 42.9% (39) of the individuals were classified as insufficiently active, compared to 57.6% (34) of individuals in the HSEL group. Taking as a parameter of physical inactivity the time of weekly physical activity < 150 minutes, there was a decrease in the classification of inactivity in both groups, although with the maintenance of higher inactivity among individuals of HSEL (49.2% vs 28.6%; p= 0.01). CONCLUSION The individuals of HSEL are more sedentary than the individuals of LSEL.

Determinants of C-Reactive Protein in Individuals with Very Low Socioeconomic Status

BACKGROUND Low socioeconomic (SE) status has been associated to inflammation and predictors of C-reactive protein (CRP) have been investigated by studies performed in developed countries. This study aimed to identify predictors of CRP in individuals of very low SE level in a developing country and evaluate whether CRP is related to SE status in this scenario. OBJECTIVE Eight-two individuals of very low SE level were recruited from a poor, semi-rural community in Brazil. Thirty-two individuals of high socioeconomic level comprised a comparison sample. High-sensitivity CRP was measured by nephelometry. METHODS Eight-two individuals of very low SE level were recruited from a poor, semi-rural community in Brazil. Thirty-two individuals of high socioeconomic level comprised a comparison sample. High-sensitivity CRP was measured by nephelometry. RESULTS In the low SE individuals, independent predictors of CRP were body mass index > 25 Kg/m(2) (P<0.001), smoking (P=0.005) and acute infection conditions (P=0.049). The low SE group (median=2.02 mg/l; interquartile range 0.92 - 4.95 mg/dl) had higher CRP levels compared to the high SE group (1.16 mg/l, interquartile range 0.55 - 2.50 mg/dl, P=0.03). Body mass index tended to be higher (27 +/- 4.9 kg/m(2) vs 25.5 +/- 3.2 kg/m(2); P=0.07) and the prevalence of acute infection greater (32% vs 3%, P=0.002) in the low SE group. After overweight individuals and those with infectious conditions were excluded, the CRP levels were similar between the groups with low and high SE levels (0.93 mg/l vs 1.08 mg/l, P=0.28). CONCLUSION Adiposity, infection conditions and smoking are predictors of CRP in individuals with very low SE level. The first two factors determine greater level of inflammation in low SE individuals when compared to the high SE counterparts.BACKGROUND: Low socioeconomic (SE) status has been associated to inflammation and predictors of C-reactive protein (CRP) have been investigated by studies performed in developed countries. This study aimed to identify predictors of CRP in individuals of very low SE level in a developing country and evaluate whether CRP is related to SE status in this scenario. OBJECTIVE: Eight-two individuals of very low SE level were recruited from a poor, semi-rural community in Brazil. Thirty-two individuals of high socioeconomic level comprised a comparison sample. High-sensitivity CRP was measured by nephelometry. METHODS: Eight-two individuals of very low SE level were recruited from a poor, semi-rural community in Brazil. Thirty-two individuals of high socioeconomic level comprised a comparison sample. High-sensitivity CRP was measured by nephelometry. RESULTS: In the low SE individuals, independent predictors of CRP were body mass index > 25 Kg/m2 (P<0.001), smoking (P=0.005) and acute infection conditions (P=0.049). The low SE group (median=2.02 mg/l; interquartile range 0.92 - 4.95 mg/dl) had higher CRP levels compared to the high SE group (1.16 mg/l, interquartile range 0.55 - 2.50 mg/dl, P=0.03). Body mass index tended to be higher (27 ± 4.9 kg/m2 vs 25.5 ± 3.2 kg/m2; P=0.07) and the prevalence of acute infection greater (32% vs 3%, P=0.002) in the low SE group. After overweight individuals and those with infectious conditions were excluded, the CRP levels were similar between the groups with low and high SE levels (0.93 mg/l vs 1.08 mg/l, P=0.28). CONCLUSION: Adiposity, infection conditions and smoking are predictors of CRP in individuals with very low SE level. The first two factors determine greater level of inflammation in low SE individuals when compared to the high SE counterparts.

Comparison of Postprandial Lipemia between Women who are on Oral Contraceptive Methods and Those who are not

Background: Postprandial Lipemia (PPL) is a physiological process that reflects the ability of the body to metabolize lipids. Even though the influence of oral contraceptives (OC) on PPL is not known, it is a known fact that their use increases fasting lipid values. Objective: To compare the PPL between women who are on OC and those who are not. Methods: A prospective analytical study which assessed eutrophic women, aged between 18 and 28 years old, who were irregularly active and with fasting triglycerides ≤150 mg/dL. They were divided into two groups: oral contraceptive group (COG) and non-oral contraceptive group (NCOG). Volunteers were submitted to the PPL test, in which blood samples were collected in time 0 (12-hour fasting) and after the intake of lipids in times 180 and 240 minutes. In order to compare the triglyceride deltas, which reflect PPL, the two-tailed Mann-Whitney test was used for independent samples between fasting collections and 180 minutes (∆1) and between fasting and 240 minutes (∆2). Results: Forty women were assessed and equally divided between groups. In the fasting lipid profile, it was observed that HDL did not present significant differences and that triglycerides in COG were twice as high in comparison to NCOG. Medians of ∆1 and ∆2 presented significant differences in both comparisons (p ≤0.05). Conclusion: The results point out that women who are irregularly active and use OC present more PPL in relation to those who do not use OC, which suggests that in this population, its chronic use increases the risk of heart conditions.

Prevalência e variáveis associadas à inatividade física em indivíduos de alto e baixo nível socioeconômico

BACKGROUND: Studies that considered only the leisure physical activity found that the physical inactivity is higher among lower-income individuals. There is a possibility that this association shows modifications, when considering transportation, work and domestic activities. OBJECTIVE: To determine whether there is a difference between the prevalence of physical inactivity between individuals of high and low socioeconomic levels. METHODS: The sample consisted of individuals of both sexes, aged 18 or older, from two groups of different socioeconomic levels. The low socioeconomic level (LSEL) group consisted of the parents of students from a public school. The high socioeconomic level (HSEL) group consisted of the parents of students from a private College. The International Physical Activity Questionnaire (IPAQ) was used to determine the level of physical activity. RESULTS: A total of 91 individuals were evaluated in the LSEL group and 59 in the HSEL group. In the LSEL group, 42.9% (39) of the individuals were classified as insufficiently active, compared to 57.6% (34) of individuals in the HSEL group. Taking as a parameter of physical inactivity the time of weekly physical activity < 150 minutes, there was a decrease in the classification of inactivity in both groups, although with the maintenance of higher inactivity among individuals of HSEL (49.2% vs 28.6%; p= 0.01). CONCLUSION: The individuals of HSEL are more sedentary than the individuals of LSEL.BACKGROUND Studies that considered only the leisure physical activity found that the physical inactivity is higher among lower-income individuals. There is a possibility that this association shows modifications, when considering transportation, work and domestic activities. OBJECTIVE To determine whether there is a difference between the prevalence of physical inactivity between individuals of high and low socioeconomic levels. METHODS The sample consisted of individuals of both sexes, aged 18 or older, from two groups of different socioeconomic levels. The low socioeconomic level (LSEL) group consisted of the parents of students from a public school. The high socioeconomic level (HSEL) group consisted of the parents of students from a private College. The International Physical Activity Questionnaire (IPAQ) was used to determine the level of physical activity. RESULTS A total of 91 individuals were evaluated in the LSEL group and 59 in the HSEL group. In the LSEL group, 42.9% (39) of the individuals were classified as insufficiently active, compared to 57.6% (34) of individuals in the HSEL group. Taking as a parameter of physical inactivity the time of weekly physical activity < 150 minutes, there was a decrease in the classification of inactivity in both groups, although with the maintenance of higher inactivity among individuals of HSEL (49.2% vs 28.6%; p= 0.01). CONCLUSION The individuals of HSEL are more sedentary than the individuals of LSEL.

Determinantes do valor da proteína C-reativa em indivíduos de nível sócio-econômico muito baixo

BACKGROUND Low socioeconomic (SE) status has been associated to inflammation and predictors of C-reactive protein (CRP) have been investigated by studies performed in developed countries. This study aimed to identify predictors of CRP in individuals of very low SE level in a developing country and evaluate whether CRP is related to SE status in this scenario. OBJECTIVE Eight-two individuals of very low SE level were recruited from a poor, semi-rural community in Brazil. Thirty-two individuals of high socioeconomic level comprised a comparison sample. High-sensitivity CRP was measured by nephelometry. METHODS Eight-two individuals of very low SE level were recruited from a poor, semi-rural community in Brazil. Thirty-two individuals of high socioeconomic level comprised a comparison sample. High-sensitivity CRP was measured by nephelometry. RESULTS In the low SE individuals, independent predictors of CRP were body mass index > 25 Kg/m(2) (P<0.001), smoking (P=0.005) and acute infection conditions (P=0.049). The low SE group (median=2.02 mg/l; interquartile range 0.92 - 4.95 mg/dl) had higher CRP levels compared to the high SE group (1.16 mg/l, interquartile range 0.55 - 2.50 mg/dl, P=0.03). Body mass index tended to be higher (27 +/- 4.9 kg/m(2) vs 25.5 +/- 3.2 kg/m(2); P=0.07) and the prevalence of acute infection greater (32% vs 3%, P=0.002) in the low SE group. After overweight individuals and those with infectious conditions were excluded, the CRP levels were similar between the groups with low and high SE levels (0.93 mg/l vs 1.08 mg/l, P=0.28). CONCLUSION Adiposity, infection conditions and smoking are predictors of CRP in individuals with very low SE level. The first two factors determine greater level of inflammation in low SE individuals when compared to the high SE counterparts.BACKGROUND: Low socioeconomic (SE) status has been associated to inflammation and predictors of C-reactive protein (CRP) have been investigated by studies performed in developed countries. This study aimed to identify predictors of CRP in individuals of very low SE level in a developing country and evaluate whether CRP is related to SE status in this scenario. OBJECTIVE: Eight-two individuals of very low SE level were recruited from a poor, semi-rural community in Brazil. Thirty-two individuals of high socioeconomic level comprised a comparison sample. High-sensitivity CRP was measured by nephelometry. METHODS: Eight-two individuals of very low SE level were recruited from a poor, semi-rural community in Brazil. Thirty-two individuals of high socioeconomic level comprised a comparison sample. High-sensitivity CRP was measured by nephelometry. RESULTS: In the low SE individuals, independent predictors of CRP were body mass index > 25 Kg/m2 (P<0.001), smoking (P=0.005) and acute infection conditions (P=0.049). The low SE group (median=2.02 mg/l; interquartile range 0.92 - 4.95 mg/dl) had higher CRP levels compared to the high SE group (1.16 mg/l, interquartile range 0.55 - 2.50 mg/dl, P=0.03). Body mass index tended to be higher (27 ± 4.9 kg/m2 vs 25.5 ± 3.2 kg/m2; P=0.07) and the prevalence of acute infection greater (32% vs 3%, P=0.002) in the low SE group. After overweight individuals and those with infectious conditions were excluded, the CRP levels were similar between the groups with low and high SE levels (0.93 mg/l vs 1.08 mg/l, P=0.28). CONCLUSION: Adiposity, infection conditions and smoking are predictors of CRP in individuals with very low SE level. The first two factors determine greater level of inflammation in low SE individuals when compared to the high SE counterparts.

Prevalencia y variables asociadas a la inactividad física en individuos de alto y bajo nivel socioeconómico

BACKGROUND: Studies that considered only the leisure physical activity found that the physical inactivity is higher among lower-income individuals. There is a possibility that this association shows modifications, when considering transportation, work and domestic activities. OBJECTIVE: To determine whether there is a difference between the prevalence of physical inactivity between individuals of high and low socioeconomic levels. METHODS: The sample consisted of individuals of both sexes, aged 18 or older, from two groups of different socioeconomic levels. The low socioeconomic level (LSEL) group consisted of the parents of students from a public school. The high socioeconomic level (HSEL) group consisted of the parents of students from a private College. The International Physical Activity Questionnaire (IPAQ) was used to determine the level of physical activity. RESULTS: A total of 91 individuals were evaluated in the LSEL group and 59 in the HSEL group. In the LSEL group, 42.9% (39) of the individuals were classified as insufficiently active, compared to 57.6% (34) of individuals in the HSEL group. Taking as a parameter of physical inactivity the time of weekly physical activity < 150 minutes, there was a decrease in the classification of inactivity in both groups, although with the maintenance of higher inactivity among individuals of HSEL (49.2% vs 28.6%; p= 0.01). CONCLUSION: The individuals of HSEL are more sedentary than the individuals of LSEL.BACKGROUND Studies that considered only the leisure physical activity found that the physical inactivity is higher among lower-income individuals. There is a possibility that this association shows modifications, when considering transportation, work and domestic activities. OBJECTIVE To determine whether there is a difference between the prevalence of physical inactivity between individuals of high and low socioeconomic levels. METHODS The sample consisted of individuals of both sexes, aged 18 or older, from two groups of different socioeconomic levels. The low socioeconomic level (LSEL) group consisted of the parents of students from a public school. The high socioeconomic level (HSEL) group consisted of the parents of students from a private College. The International Physical Activity Questionnaire (IPAQ) was used to determine the level of physical activity. RESULTS A total of 91 individuals were evaluated in the LSEL group and 59 in the HSEL group. In the LSEL group, 42.9% (39) of the individuals were classified as insufficiently active, compared to 57.6% (34) of individuals in the HSEL group. Taking as a parameter of physical inactivity the time of weekly physical activity < 150 minutes, there was a decrease in the classification of inactivity in both groups, although with the maintenance of higher inactivity among individuals of HSEL (49.2% vs 28.6%; p= 0.01). CONCLUSION The individuals of HSEL are more sedentary than the individuals of LSEL.

Endothelial Effect of Statin Therapy at a High Dose Versus Low Dose Associated with Ezetimibe

Background The effect of statins on the endothelial function in humans remains under discussion. Particularly, it is still unclear if the improvement in endothelial function is due to a reduction in LDL-cholesterol or to an arterial pleiotropic effect. Objective To test the hypothesis that modulation of the endothelial function promoted by statins is primarily mediated by the degree of reduction in LDL-cholesterol, independent of the dose of statin administered. Methods Randomized clinical trial with two groups of lipid-lowering treatment (16 patients/each) and one placebo group (14 patients). The two active groups were designed to promote a similar degree of reduction in LDL-cholesterol: the first used statin at a high dose (80 mg, simvastatin 80 group) and the second used statin at a low dose (10 mg) associated with ezetimibe (10 mg, simvastatin 10/ezetimibe group) to optimize the hypolipidemic effect. The endothelial function was assessed by flow-mediated vasodilation (FMV) before and 8 weeks after treatment. Results The decrease in LDL-cholesterol was similar between the groups simvastatin 80 and simvastatin 10/ezetimibe (27% ± 31% and 30% ± 29%, respectively, p = 0.75). The simvastatin 80 group presented an increase in FMV from 8.4% ± 4.3% at baseline to 11% ± 4.2% after 8 weeks (p = 0.02). Similarly, the group simvastatin 10/ezetimibe showed improvement in FMV from 7.3% ± 3.9% to 12% ± 4.4% (p = 0.001). The placebo group showed no variation in LDL-cholesterol level or endothelial function. Conclusion The improvement in endothelial function with statin seems to depend more on a reduction in LDL-cholesterol levels, independent of the dose of statin administered, than on pleiotropic mechanisms.

Postprandial lipemia and subclinical inflammation on active women taking oral contraceptive

Fundamentos: Mulheres em uso de contraceptivo oral combinado (COC) apresentam perfil lipidico de jejum, lipemia pos-prandial (LPP) e proteina C-reativa (PCR) maiores do que mulheres que nao utilizam COC. O exercicio fisico apresenta bons resultados no controle lipidico e inflamatorio. Objetivo: Comparar os valores do perfil lipidico de jejum, da LPP e da PCR entre mulheres ativas e irregularmente ativas em uso de COC. Metodos: Avaliadas 44 mulheres em uso de COC, da cidade de Salvador, BA, estratificadas em dois grupos: grupo ativo (GA; n=22) formado por mulheres fisicamente ativas e grupo irregularmente ativo (GIA; n=22) formado por mulheres irregularmente ativas. Nos dois grupos, apos jejum de 12 horas, realizada a dosagem do perfil lipidico de jejum e da PCR. A seguir, as voluntarias ingeriram um composto contendo 25 g de gordura e foram dosados os triglicerideos para verificar a LPP. Utilizado o teste de Mann-Whitney para comparacao da LPP e PCR. Resultados: Os valores dos deltas dos triglicerideos que representam a LPP respectivamente para o GA e GIA foram: 93±38,4 mg/dL vs. 163±49,6 mg/dL e 89±50,9 mg/dL vs. 156±47,6 mg/dL (p˂0,01). Os valores da PCR respectivamente para GA e GIA foram: 1,1 mg/L (0,4-2,1 mg/L) e 2,1 mg/L (0,8-3,4 mg/L) (p=0,04). Conclusao: Neste estudo, mulheres ativas em uso de COC apresentaram triglicerideos e LDL de jejum, LPP e PCR significativamente menores que mulheres irregularmente ativas em uso de COC.

Cardiovascular risk profile in patients with myelopathy associated with HTLV-1☆

HAM/TSP (HTLV-1-associated myelopathy/tropical spastic paraparesis) is a slowly progressive disease, characterized by a chronic spastic paraparesis. It is not known if the disease carries an independent risk for cardiovascular disease. The objective of this study was to evaluate the cardiovascular risk profile related to HAM/TSP and compare it with the general population. METHODS This was a cross-sectional study, with a control group. HAM/TSP patients were evaluated using cardiovascular risk scores (ASCVD RISK, SCORE and Framingham) and inflammatory markers (ultrasensitive CRP and IL-6), and compared with a control group of healthy individuals. We also evaluated the correlation between cardiovascular risk and the functional status of patients with HAM/TSP evaluated by the FIM scale. RESULTS Eighty percent of patients in this study were females, mean age of 51 years (11.3). The control group showed an increased cardiovascular event risk in 10 years when ASCVD was analyzed (cardiovascular risk ≥7.5% in 10 years seen in 43% of patients in the control group vs. 23% of patients with HAM/TSP; p=0.037). There was no difference in ultrasensitive CRP or IL-6 values between the groups, even when groups were stratified into low and high risk. There was no correlation between the functional status of HAM/TSP patients and the cardiovascular risk. CONCLUSIONS In this study, the cardiovascular risk profile of patients with HAM/TSP was better than the risk of the control group.